A78 Abstracts PMH22 HEALTH CARE COSTS AND RESOURCE USE IN PATIENTS WITH MAJOR DEPRESSIVE DISORDER:A COMPARISON BETWEEN ESCITALOPRAM AND OTHER ANTIDEPRESSANTS W u E 1 ,Yang E 1 , Greenberg P 1 , Erder H 2 ,Yu AP 1 , Buesing M 1 1 Analysis Group, Inc, Boston, MA, USA, 2 Forest Research Institute, Jersey City, NJ, USA OBJECTIVES: To compare the health care costs and utilization of adult major depressive disorder (MDD) patients treated with escitalopram to those treated with other SSRI/SNRI. METHODS: MDD patients (age ≥ 18) initiated on escitalopram or other SSRI/SNRI were identified in the IHCIS National Managed Care Database (2003–2005). Health care costs and resource use of patients on escitalopram were compared to patients on other antidepressants over the 6 months following therapy initiation (study period). Wilcoxon tests were used to compare costs descriptively. GLM regressions with log link func- tion were used for cost comparison. Two-part regression models were used to deal with zero cost. Logistic regressions were used to compare 6-month rates of hospitalization, emergency visit, and substance abuse. Negative binomial regressions were used to compare the number of hospitalization days and emergency visits. All regressions adjusted for patient demographics, comor- bidities, and baseline medical resource use. Costs were inflation adjusted to 2005 US dollars. RESULTS: The study sample included 10,465 MDD patients initiated on escitalopram and 28,310 patients initiated on other SSRI/SNRI. Descriptive analy- ses showed that escitalopram patients had on average $753 lower 6-month total health care costs than patients on other SSRI/SNRI (p < 0.0001), with more than half of the difference from lower hospitalization costs ($394, p < 0.0001). GLM regressions showed that escitalopram patients cost $839 less (p < 0.0001) in total health care costs and $405 less (p < 0.01) in inpatient costs. Medical resource utilization regressions showed that, compared to patients on other SSRI/SNRI, patients on esc- italopram were less likely to have hospitalization (p = 0.0001), emergency visit (p < 0.0001), and substance abuse (p = 0.001). Escitalopram patients had 31% fewer hospitalization days (p < 0.0001) and 15% fewer emergency visits (p < 0.0001). CON- CLUSION: Compared to adult MDD patients initiated on other SSRI/SNRI, patients on escitalopram have lower health care costs and utilize fewer medical resources. PMH23 ECONOMIC EVALUATION OF LONG ACTING TREATMENTS FOR ATTENTION-DEFICIT/HYPERACTIVITY DISORDER IN THE MILITARY HEALTH SYSTEM De vine JW , Moore E,Tiller KW,Trice S, Meade DJ, Lawrence JB Department of Defense Pharmacoeconomic Center, Fort Sam Houston, TX, USA OBJECTIVES: To evaluate the cost-effectiveness of frequently used long acting treatments for children and adolescents with attention-deficit/hyperactivity disorder (ADHD) in the U.S. Mil- itary Health System (MHS). METHODS: A decision analytic model compared the cost-effectiveness of three commonly used long acting treatments for ADHD in the MHS (methylphenidate OROS, mixed amphetamine salts extended-release, and atom- oxetine) to treatment with methylphenidate immediate-release (MPH IR) over a one year time horizon. Inputs for model para- meters were derived from published literature. Treatment effi- cacy was estimated from a mixed treatment comparison model of published randomized controlled trials with response to treat- ment defined as either very much improved or much improved on the physician-rated Clinical Global Impression of Improve- ment scale. Health care costs were measured from a MHS per- spective in dollars and drug costs were based on Federal Supply Schedule prices. Treatment outcomes were measured in quality- adjusted life-years (QALYs). The model considered two scenar- ios. One of equal patient preference for response to treatment and another that assumed a greater preference for response with extended-release and non-stimulant products compared to MPH IR. Model uncertainty was evaluated with probabilistic sen- sitivity analyses and cost-effectiveness acceptability curves. RESULTS: Under a scenario of equal patient preferences, methylphenidate OROS was slightly more effective than MPH IR with an estimated incremental cost-effectiveness ratio (ICER) of $111,536/QALY. Greater patient preference for extended- release and non-stimulant products increased the estimated benefit of the long acting treatments. This improvement lowered the ICER for methylphenidate OROS to $27,214/QALY com- pared to MPH IR. Atomoxetine was also on the cost-effective- ness frontier at an additional cost of $34,239/QALY compared to treatment with methylphenidate OROS. Under both scenar- ios, mixed amphetamine salts extended-release was dominated by methylphenidate OROS. CONCLUSION: Long acting treat- ments for ADHD in the MHS were cost-effective at commonly accepted thresholds only under a scenario that assumed greater patient preference for response to these products. PMH24 36-MONTH COST-UTILITY ANALYSIS OF ANTIPSYCHOTIC TREATMENTS IN PATIENTS WITH SCHIZOPHRENIA IN THE PAN-EUROPEAN SOHO (SCHIZOPHRENIA OUTPATIENT HEALTH OUTCOMES) STUDY Windmeijer F 1 , Brown J 2 , No vick D 2 , Hong J 3 , Knapp M 3 , Kontodimas S 2 , Ratcliffe M 2 1 University of Bristol, Bristol, UK, 2 Eli Lilly and Company Limited, Windlesham, Surrey, UK, 3 London School of Economics, London, UK OBJECTIVES: To determine the cost-effectiveness (measured using an incremental cost-utility ratio) of treating schizophrenia patients with olanzapine versus risperidone, clozapine, quetiap- ine, amisulpride, oral typical and depot typical antipsychotics. METHODS: European SOHO is a 3-year, prospective, outpa- tient, observational study associated with antipsychotic treat- ment in 10 European countries. Health care resource use and quality of life data (EuroQol EQ-5D and UK population utility values) were collected at baseline, 3, 6, 12, 18, 24, 32 and 36 months. UK health care costs were applied to the resource use data for the 10 countries. Pair-wise incremental costs and utili- ties were estimated between olanzapine-treated patients and patients treated with each of the other antipsychotics. Utility increments were used to estimate quality-adjusted life-years (QALYs) gained. Incremental cost-utility ratios were expressed as the additional cost per QALY gained. Bootstrap replications provided an estimate of uncertainty. RESULTS: 10,972 patients were enrolled at baseline, 65% were eligible for analyses at 36 months. Treatment with olanzapine is more effective and less costly than clozapine and quetiapine. Treatment with olanzap- ine is more effective but more costly compared to treatment with risperidone, amisulpride, and oral typical or depot typical antipsychotics. The incremental cost-utility ratios of olanzapine versus these four medications were £12,343, £1586, £14,849 and £23,379 per additional QALYs gained respectively. The bootstrap replications for uncertainty showed that 100% of the replications fell below a £30,000 per QALY threshold in the comparison with quetiapine and oral typicals. It was 98%, 91%, 99% and 79% for the comparison with risperidone, clozapine, amisulpride and depot typicals respectively. CONCLUSION: Among SOHO patients, if a funding threshold of £30,000 per QALY gained is assumed, olanzapine has a high probability of